After Damar Hamlin's on-field collapse, mandated AED training clears Ohio House

COLUMBUS, Ohio (WCMH) – In September 2021, a sole lawmaker put forth a law that would require the use and proper maintenance of automatic external defibrillators in schools and recreation centers. 

That bill “didn’t go very far,” its sponsor, Rep. Richard Brown (D-Canal Winchester) remarked on Wednesday – it had one committee hearing before falling off the statehouse radar. 

But then in January, Buffalo Bills safety Damar Hamlin went into sudden cardiac arrest on national television during a game against the Bengals in Cincinnati, by all accounts providing the public push needed to address the leading cause of death among young athletes.

The Ohio House of Representatives overwhelmingly voted to pass House Bill 47 on Wednesday afternoon, requiring all schools and most sporting event and practice venues to have clearly marked automatic external defibrillators, updated emergency action plans for cardiac events and AED and CPR training for employees. The bipartisan legislation came backed by the full force of the Smart Heart Sports Coalition, a group of athletic organizations founded by the NFL in March that wants every state to enact similar laws.

“A person’s chances of surviving a cardiac arrest greatly increase when every link of that chain of survival is ready to respond to the emergency, and that’s what legislation like House Bill 47 will accomplish,” Dustin Holfinger, state governmental relations director for the American Heart Association, said at a press conference about the legislation Wednesday.

The bill requires all schools to have AEDs in every building, including athletic facilities, and it requires towns and cities to have the devices in all recreational facilities, including outdoor fields and swimming pools. Both municipalities and schools must have a frequently updated emergency action plan clearly posted with the AEDs, and principals, teachers, coaches, athletic trainers and recreation center employees must receive CPR and AED training. 

The Department of Health will develop a model cardiac emergency action plan for schools and cities to use, the legislation mandates. 

Sudden cardiac arrest occurs when the heart experiences an electrical malfunction, disrupting the flow of blood to the brain, lungs and other organs, according to the American Heart Association. Without medical intervention – including CPR and the use of an AED – a person can die in minutes.

It is the leading cause of death among young athletes, according to the Mayo Clinic, and risk factors for young people include undetected heart defects and hard hits to the chest – like the one then-24-year-old Hamlin experienced shortly before he collapsed and stopped breathing.

Millions of Americans watched the response to Hamlin’s collapse unfold in real time, as CPR began within moments while waiting for medical personnel to restart his heart. The response – and Hamlin’s miraculous recovery – became the “inspiration and impetus” for the Smart Heart Sports Coalition’s advocacy, said Ken Edmonds, vice president of public policy and government affairs at the NFL. 

Not every victim of sudden cardiac arrest is so lucky, however. 

Out-of-hospital cardiac arrests have an 85% mortality rate, according to the American Heart Association. For each minute that defibrillation is delayed, a person’s chances of survival decrease by 10%, said Corey Paul, executive director of the American Red Cross.

Nicole Ward’s husband, Paul, was 32 steps away from an AED when he collapsed during a cycling class in 2016, she said. Gym staff called emergency services – and Ward – but it wasn’t until she got to the hospital that she learned Paul had stopped breathing.

“Time was of the essence, but in the critical moments while he was still at the gym prior to EMS arriving, no one performed CPR or took the initiative to use the AED that was perfectly mounted like a framed picture for everyone to see but never to be touched,” Ward said.

Ward is the executive director of Make Them Know Your Name Foundation, started by her son – and Cleveland Browns cornerback – Denzel, in honor of his father, who did not survive. 

AEDs cost about $1,500 apiece, HB47’s co-sponsor, Rep. Adam Bird (R-Madison Twp.) noted, waving away the notion that the bill is an unfunded mandate that leaves districts, schools and municipalities on the hook for more stringent requirements. Recognizing that the policy may put a hefty burden on Ohio’s smallest communities, the bill carves out an exception for townships and villages with fewer than 5,000 people.

As far as any burden shoveled onto schools, Bird noted both at the press conference and on the House floor that 99% of Ohio schools already have AEDs. 

“This will mean something to 1% of the schools in Ohio that do not have an AED,” Bird said at the press conference. “To me, this shouldn’t be an issue.”

Brown agreed with Bird, adding while most schools might already have AEDs, the law codifies proper training and rehearsing of emergency action plans – things that are necessary to save lives.

“An AED is only good if it’s used, it’s only good if someone knows how to use them,” Brown said. “They’re available almost everywhere, but if they’re not maintained properly, if the batteries aren’t charged properly, they’re meaningless.”

HB47 will now go to the Senate for consideration.